Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August ...Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.展开更多
BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and o...BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.展开更多
Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether...Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional（2D） video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods： This cross-sectional study recruited 130 female basketball players（258 legs） from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in（KID） and hip-out（HOD） distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test（DTT） and a dynamic heel-floor test（HFT）.Results： The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats（28.7%） and singleleg drop landings（23.3%）. The prevalence of HFT-positivity was significantly greater during landings（51.4%） than during single-leg squats（31.0%, p 〈 0.01）. The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group（15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001）. The HOD values were similarly greater in the DTT-positive group（15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001）. The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group（12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001）, whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion： Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.展开更多
Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in ad...Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.展开更多
目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFN...目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。展开更多
目的观察针刺结合七氟烷维持麻醉对髋关节置换患者近远期认知功能及免疫功能的影响。方法选择2022年10月-2023年10月在该院接受治疗的82例髋关节置换术患者,经随机数字表法分为对照组、研究组,均41例,对照组予以硬膜外复合七氟烷维持麻...目的观察针刺结合七氟烷维持麻醉对髋关节置换患者近远期认知功能及免疫功能的影响。方法选择2022年10月-2023年10月在该院接受治疗的82例髋关节置换术患者,经随机数字表法分为对照组、研究组,均41例,对照组予以硬膜外复合七氟烷维持麻醉,研究组在对照组基础上联合针刺。对比两组麻醉恢复时间,手术前后白介素细胞-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、S-100β浓度、免疫功能(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)、视觉模拟评分(Visual analog scale,VAS)、平均动脉压和心率,观察两组术后3 d和术后6个月的术后认知功能障碍(Post operative cognitive dysfunction,POCD)发生情况。结果研究组苏醒、拔管和定向力恢复时间较较对照组少(P<0.05)。两组术前IL-6、TNF-α、S-100β及免疫功能无差异(P>0.05);两组术后3 d IL-6、TNF-α、S-100β、CD_(8)^(+)均增加,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均下降,研究组以上指标变化更小(P<0.05)。两组术前MoCA、VAS评分无差异(P>0.05);两组术后3 d MoCA、VAS评分均较术前低,组间及组内均有差异(P<0.05),两组术后6个月MoCA评分无差异(P>0.05)。两组入室时平均动脉压、心率无差异(P>0.05);两组拔管时平均动脉压、心率均较术前上升,组间及组内均有差异(P<0.05)。研究组术后3 d POCD发生率较对照组低(P<0.05),两组术后6个月POCD发生率无差异(P>0.05)。结论针刺结合七氟烷维持麻醉有利于髋关节置换患者认知功能的恢复,对免疫功能的影响小,术中血流动力学平稳,安全性高。展开更多
目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方...目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方入路THA治疗,对照组采用后外侧入路THA治疗,比较两组手术相关指标[切口长度、住院时间、术中出血量、术后72 h视觉模拟评分法(VAS)评分、术后引流量]水平,手术前后炎性指标[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、淀粉样蛋白A(SAA)]水平、术后髋关节功能[Charnley髋关节疗效量表(CHS)、Harris髋关节功能量表(HSS)]评分,以及并发症发生率。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组切口长度、住院时间均短于对照组,术中出血量、术后引流量均少于对照组,术后72 h VAS评分低于对照组,差异有统计学意义(P<0.05);术后3 d,两组hs-CRP、IL-1β、SAA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1个月,观察组CHS、HHS评分均高于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组CHS、HHS评分均高于术后1个月,但组间比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:直接前方入路THA治疗股骨颈骨折患者可缩短切口长度和住院时间,减少术中出血量和术后引流量,降低疼痛评分和炎性指标水平,以及提高髋关节功能评分的效果优于后外侧入路THA治疗。展开更多
AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis wa...AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.展开更多
文摘Objective:To evaluate the treatment effect of total hip arthroplasty(THA)for intertrochanteric femur fractures(IFF)in elderly patients.Methods:Thirty-two elderly patients with IFF admitted to the hospital from August 2021 to August 2024 were selected and randomly divided into two groups using a random number table.The experimental group(16 patients)underwent THA surgery,while the control group(16 patients)underwent proximal femoral nail antirotation(PFNA)surgery.Hip joint function and quality of life indicators were compared between the two groups.Results:Before surgery,there was no significant difference in hip joint function and quality of life scores between the two groups(P>0.05).However,at six months postoperatively,the experimental group had higher hip joint function and quality of life scores compared to the control group(P<0.05).The total effective rate was higher in the experimental group than in the control group(P<0.05).The complication rate in the experimental group was similar to that in the control group(P>0.05).Conclusion:THA can improve the clinical efficacy of elderly patients with IFF,minimize postoperative complications,effectively restore hip joint function,and optimize postoperative quality of life.
基金Supported by Leading Talents Training Program of Pudong New Area Health Commission,No.PWR 12020-06and Shanghai Science and Technology Commission,No.20Y11901800.
文摘BACKGROUND Excellent hip joint function facilitates limb recovery and improves the quality of survival.This study aimed to investigate the potential risk factors affecting postoperative joint functional activity and outcomes in elderly hip fractures patients and to provide evidence for patient rehabilitation and clinical management.AIM To explore the relationship between inflammatory factors and hip function and the interaction between inflammation and health after hip fracture in elderly patients.METHODS The elderly patients who had hip fracture surgery at our hospital between January 1,2021,and December 31,2022 were chosen for this retrospective clinical investigation.Patients with excellent and fair postoperative hip function had their clinical information and characteristics gathered and compared.Age,gender,fracture site,surgical technique,laboratory indices,and other variables that could have an impact on postoperative joint function were all included in a univariate study.To further identify independent risk factors affecting postoperative joint function in hip fractures,risk factors that showed statistical significance in the univariate analysis were then included in a multiple logistic regression analysis.In addition to this,we also compared other outcome variables such as visual analogue scale and length of hospital stay between the two groups.RESULTS A total of 119 elderly patients with hip fractures were included in this study,of whom 37 were male and 82 were female.The results of univariate logistic regression analysis after excluding the interaction of various factors showed that there was a statistically significant difference in interleukin(IL)-6,IL-8,IL-10,C-reactive protein(CRP),and complement C1q(C1q)between the fair and excellent joint function groups(P<0.05).The results of multiple logistic regression analysis showed that IL-6>20 pg/mL[Odds ratio(OR)3.070,95%CI:1.243-7.579],IL-8>21.4 pg/mL(OR 3.827,95%CI:1.498-9.773),CRP>10 mg/L(OR 2.142,95%CI:1.020-4.498)and C1q>233 mg/L(OR 2.339,95%CI:1.094-5.004)were independent risk factors for poor joint function after hip fracture surgery(all P<0.05).CONCLUSION After hip fractures in older patients,inflammatory variables are risk factors for fair joint function;therefore,early intervention to address these markers is essential to enhance joint function and avoid consequences.
文摘Background： Preventing anterior cruciate ligament（ACL） injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional（2D） video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods： This cross-sectional study recruited 130 female basketball players（258 legs） from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in（KID） and hip-out（HOD） distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test（DTT） and a dynamic heel-floor test（HFT）.Results： The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats（28.7%） and singleleg drop landings（23.3%）. The prevalence of HFT-positivity was significantly greater during landings（51.4%） than during single-leg squats（31.0%, p 〈 0.01）. The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group（15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001）. The HOD values were similarly greater in the DTT-positive group（15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001）. The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group（12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001）, whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion： Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.
文摘Objective: To examine gender differences in self-reported pain and function before and after hip replacement surgery and the extent to which overweight, comorbidities and muscular status impact pain and function in adults with disabling end-stage hip joint osteoarthritis. Setting: Orthopedic Hospital Setting on the East Coast of the United States. Study Design: Cross-sectional retrospective chart review. Methods: The desired demographic, physical and psychological attributes of 1040 adults with end-stage hip osteoarthritis hospitalized for hip surgery were recorded and subjected to comparison and correlational analyses. These data included gender, self-reported weight, height, numbers and nature of physical and psychological comorbidities, pain intensity, ambulatory capacity and discharge destination. Sub-group analyses of 808 candidates hospitalized for primary unilateral surgery were also conducted using SPSS 16. Results: There were significant (p 【0.05) associations between gender, pain scores, comorbidity numbers and ambulatory capacity. Specifically, women who exhibited higher comorbid disease rates than men, exhibited higher pre-surgery pain levels and greater functional limitations in walking ability before and after surgery than men with the same condition. In sub-group analyses of men and women with the same mean age, comorbid prevalence rates, and body mass indices, women were found to have significantly higher ideal weights on average than men, and those with higher ideal weights recovered more slowly after surgery (p 【0.05). Conclusion: The presentation of hip joint osteoarthritis is not uniform, and may be impacted differentially by gender. Women with high ideal body weights, may be specifically impacted. Whether genetic or other factors account for gender differences in pain and function among adults with disabling hip osteoarthritis observation needs to be examined.
文摘目的探讨不同长度股骨近端防旋髓内钉(PFNA)主钉治疗31-A3.1~A3.3型股骨转子间骨折(IFF)患者的效果。方法选取2022年9月至2024年10月收治的150例31-A3.1~A3.3型IFF患者进行前瞻性研究。随机数字表法分为长钉组、短钉组各75例。长钉组PFNA选择加长型主钉,短钉组PFNA选择普通型主钉。比较两组围术期指标、骨折愈合时间、完全负重时间、住院时间,复位质量、术后稳定性、手术创伤应激因子[超氧化物歧化酶(SOD)、血管紧张素Ⅱ(AngⅡ)、去甲肾上腺素(NE)]水平、髋关节活动度[髋伸屈活动度(ROM)、髋内-外旋ROM]、髋关节功能及并发症。结果相较于短钉组,长钉组患者手术时间、住院时间较长,失血量、术中X线透视次数较多,完全负重时间、骨折愈合时间较短(P<0.05);两组患者复位质量比较差异无统计学意义(P>0.05);长钉组患者术后稳定性优于短钉组(P<0.05);长钉组患者术后1、3 d SOD低于短钉组,AngⅡ、NE高于短钉组(P<0.05);术后3、6个月两组髋伸屈、髋内-外旋ROM比较差异无统计学意义(P>0.05);长钉组髋关节功能优良率[98.67%(74/75)]较短钉组[89.33%(67/75)]高(P<0.05);长钉组并发症总发生率[1.33%(1/75)]与短钉组[2.67%(2/75)]比较差异无统计学意义(P>0.05)。结论与普通型PFNA主钉相比,采用加长型PFNA主钉治疗31-A3.1~A3.3型IFF患者能促进骨折愈合,提高术后稳定性,改善患者髋关节功能,安全性良好,但创伤较大,围术期恢复较慢。
文摘目的观察针刺结合七氟烷维持麻醉对髋关节置换患者近远期认知功能及免疫功能的影响。方法选择2022年10月-2023年10月在该院接受治疗的82例髋关节置换术患者,经随机数字表法分为对照组、研究组,均41例,对照组予以硬膜外复合七氟烷维持麻醉,研究组在对照组基础上联合针刺。对比两组麻醉恢复时间,手术前后白介素细胞-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、S-100β浓度、免疫功能(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、蒙特利尔认知评估量表(Montreal cognitive assessment scale,MoCA)、视觉模拟评分(Visual analog scale,VAS)、平均动脉压和心率,观察两组术后3 d和术后6个月的术后认知功能障碍(Post operative cognitive dysfunction,POCD)发生情况。结果研究组苏醒、拔管和定向力恢复时间较较对照组少(P<0.05)。两组术前IL-6、TNF-α、S-100β及免疫功能无差异(P>0.05);两组术后3 d IL-6、TNF-α、S-100β、CD_(8)^(+)均增加,CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均下降,研究组以上指标变化更小(P<0.05)。两组术前MoCA、VAS评分无差异(P>0.05);两组术后3 d MoCA、VAS评分均较术前低,组间及组内均有差异(P<0.05),两组术后6个月MoCA评分无差异(P>0.05)。两组入室时平均动脉压、心率无差异(P>0.05);两组拔管时平均动脉压、心率均较术前上升,组间及组内均有差异(P<0.05)。研究组术后3 d POCD发生率较对照组低(P<0.05),两组术后6个月POCD发生率无差异(P>0.05)。结论针刺结合七氟烷维持麻醉有利于髋关节置换患者认知功能的恢复,对免疫功能的影响小,术中血流动力学平稳,安全性高。
文摘目的:比较直接前方入路与后外侧入路全髋关节置换术(THA)治疗股骨颈骨折患者的效果。方法:回顾性分析2022年1月至2025年1月该院收治的82例股骨颈骨折患者的临床资料,根据手术入路不同将其分为观察组和对照组各41例。观察组采用直接前方入路THA治疗,对照组采用后外侧入路THA治疗,比较两组手术相关指标[切口长度、住院时间、术中出血量、术后72 h视觉模拟评分法(VAS)评分、术后引流量]水平,手术前后炎性指标[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、淀粉样蛋白A(SAA)]水平、术后髋关节功能[Charnley髋关节疗效量表(CHS)、Harris髋关节功能量表(HSS)]评分,以及并发症发生率。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组切口长度、住院时间均短于对照组,术中出血量、术后引流量均少于对照组,术后72 h VAS评分低于对照组,差异有统计学意义(P<0.05);术后3 d,两组hs-CRP、IL-1β、SAA水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后1个月,观察组CHS、HHS评分均高于对照组,差异有统计学意义(P<0.05);术后3、6个月,两组CHS、HHS评分均高于术后1个月,但组间比较,差异均无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:直接前方入路THA治疗股骨颈骨折患者可缩短切口长度和住院时间,减少术中出血量和术后引流量,降低疼痛评分和炎性指标水平,以及提高髋关节功能评分的效果优于后外侧入路THA治疗。
基金Canadian Institute of Health Science(CIHR)and Zimmer,Warsaw,United States
文摘AIM: To determine hip joint center(HJC) location on hip arthroplasty population comparing predictive and functional approaches with radiographic measurements.METHODS: The distance between the HJC and the mid-pelvis was calculated and compared between the three approaches. The localisation error between the predictive and functional approach was compared using the radiographic measurements as the reference. The operated leg was compared to the non-operated leg.RESULTS: A significant difference was found for the distance between the HJC and the mid-pelvis when comparing the predictive and functional method. The functional method leads to fewer errors. A statistical difference was found for the localization error between the predictive and functional method. The functional method is twice more precise.CONCLUSION: Although being more individualized, the functional method improves HJC localization and should be used in three-dimensional gait analysis.
